Patients’ Experiences of Recovery: Beyond the Intensive Care Unit and into the Community

Aims To understand barriers and facilitators of recovery for critical illness survivors’, who are discharged home from the hospital and do not have access to dedicated outpatient care. Design Multi-site descriptive study guided by interpretive phenomenology using semi-structured interviews. Methods Interviews were conducted between December 2017 -July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors’ personal experiences and perception of those experiences. Results Participants encountered several barriers to their recovery; however, they were resilient and initiated ways to overcome these barriers and assist with their recovery. Facilitators of recovery experienced by survivors included seeking support from family and friends, lifestyle adaptations, and creative management of their multiple medical needs. Barriers included unmet needs experienced by survivors such as mental health issues, coordination of care, and spiritual needs. These unmet needs left participants feeling unsupported from healthcare providers during their recovery. Conclusion This study highlights important barriers and facilitators experienced by critical illness survivors during recovery that need be addressed by healthcare providers. New ways to support critical illness survivors, that can reach a broader population, must be developed and evaluated to support survivors during their recovery in the community. Impact This study addressed ICU survivors’ barriers and facilitators to recovery. Participants encountered several barriers to recovery at home, such as physical, cognitive, psychosocial, financial, and transportation barriers, however, these survivors were also resilient and resourceful in the development of strategies to try to manage their recovery at home. These results will help healthcare providers develop interventions to better support ICU survivors in the community

Identification of Off-Flavor Compounds in Beef Round and Chuck Muscles

Volatile off-flavor compounds are present in beef. Using purge and trap gas chromatography and mass spectrometry, some volatile compounds were shown to have different concentrations in normal-flavored beef, compared to samples with liver-like off-flavor. Most of the compounds, like pentanol, hexanal, hexanol, 1–octen–3–ol, and nonanol, are associated with lipid oxidation. The compounds, β-pinene and 1-octen-3-ol were in higher concentration in the liver-like samples in all muscles tested. Several, small, unidentified peaks also differed between samples. Determination of the possible origins of these compounds may improve the quality and consistency of beef products

Flavor Relationships among Muscles form the Beef Chuck and Round

This research compared off-flavor notes and the relationship of pH and heme-iron content to off-flavor for different beef muscles. After grading, knuckles and shoulder clods were removed from 16 USDA Choice and 14 USDA Select beef carcasses, vacuum- packaged, and aged for 7 d. The rectus femoris (REC), vastus medalis (VAM), vastus lateralis (VAL), teres major (TER), infraspinatus (INF), and triceps brachii-long head (TRI) were separated, cut into steaks, and frozen (−16°C). Sensory analysis was conducted using a trained taste panel, with steaks grilled to an internal temperature of 65°C. Heme-iron concentration and pH were determined. The INF had lower (P \u3c 0.05) off-flavor intensity ratings and less frequent sour flavor than the other muscles, and the VAL had the most intense (P \u3c 0.05) off-flavor ratings and among the greatest frequency of sour, charred, and oxidized flavors. The frequencies of liver-like, bloody, and rancid flavors were not affected by muscle type. Heme-iron concentration did not differ among muscles. Three USDA Select carcasses had intense off-flavor in the muscles. Liver-like flavor was highly negatively correlated with off-flavor intensity for each of the muscles tested. Muscles rated a 5 or below (on an 8-point rating scale, where 1 = extremely intense off-flavor and 8 = no off-flavor) in off-flavor intensity and identified as liver-like by 30% or more of the panelists were grouped together and compared to normal muscles. Those in the liver-flavored group were less frequently identified as charred, probably because the liver-like flavor was so intense. There were no differences between the 2 groups for sour, metallic, bloody, oxidized, or fatty off-flavor notes. Regression equations containing the linear and quadratic functions of heme-iron concentration, muscle pH, and their interaction were established for the frequency of off-flavor notes within each muscle. The REC, TER, VAL, and VAM showed a relationship between pH, heme iron, and off-flavor intensity (P \u3c 0.05). Liver-like flavor was explained partially by pH and heme iron in the REC, VAM, and VAL (R2 = 0.45 to 0.55; P \u3c 0.05). Few other significant relationships were found. Heme iron and pH were unrelated to metallic, oxidized, or rancid flavors for any of the muscles tested. These data suggest that liver-like off-flavors are specific to individual animals, and that pH and heme iron are not strongly related to off-flavor notes

Strongly Variable z=1.48 FeII and MgII Absorption in the Spectra of z=4.05 GRB 060206

We report on the discovery of strongly variable FeII and MgII absorption lines seen at z=1.48 in the spectra of the z=4.05 GRB 060206 obtained between 4.13 to 7.63 hours (observer frame) after the burst. In particular, the FeII line equivalent width (EW) decayed rapidly from 1.72+-0.25 AA to 0.28+-0.21 AA, only to increase to 0.96+-0.21 AA in a later date spectrum. The MgII doublet shows even more complicated evolution: the weaker line of the doublet drops from 2.05+-0.25 AA to 0.92+-0.32 AA, but then more than doubles to 2.47+-0.41 AA in later data. The ratio of the EWs for the MgII doublet is also variable, being closer to 1:1 (saturated regime) when the lines are stronger and becoming closer to 2:1 (unsaturated regime) when the lines are weaker, consistent with expectations based on atomic physics. We have investigated and rejected the possibility of any instrumental or atmospheric effects causing the observed strong variations. Our discovery of clearly variable intervening FeII and MgII lines lends very strong support to their scenario, in which the characteristic size of intervening patches of MgII ``clouds'' is comparable to the GRB beam size, i.e, about 10^16 cm. We discuss various implications of this discovery, including the nature of the MgII absorbers, the physics of GRBs, and measurements of chemical abundances from GRB and quasar absorption lines.Comment: 14 pages, 3 figures, 1 table; ApJ Letters, accepte

Voltage analysis after multi-electrode ablation with duty-cycled bipolar and unipolar radiofrequency energy: a case report

Pulmonary vein ablation with a single-tip catheter remains long and complex. We describe a typical case of a novel efficient technique with a decapolar ring catheter utilizing alternating unipolar/bipolar radiofrequency energy. Voltage analysis and electrical mapping demonstrate the potential for antrum ablation and pulmonary vein isolation

An Integrated Conceptual Framework Linking Attachment Insecurity to Increased Risk for Both Enacting and Experiencing Objectification

Sexual objectification (i.e., reducing a person to their appearance, body, or sex appeal and functions) is a significant risk factor for negative health outcomes. In the present investigation, we examined multiple manifestations of objectification (i.e., objectification of others, objectification of self, and objectification by others) in an interpersonal context. We merged objectification theory with attachment theory, one of the most prominent theories of close relationships, and propose that sexual objectification can shed light on attachment processes (and vice versa). To bolster this conceptual overlap, we tested this novel, integrated framework across two independent samples of women and men including (a) a sample of 813 undergraduate students—both partnered and single—who completed self-report questionnaires of attachment security and multiple forms of objectification and (b) a sample of 159 committed couples navigating pregnancy who were observed during naturalistic interactions to assess attachment security and completed self-report questionnaires of attachment security and objectification (including partner objectification). Results from both studies demonstrate the utility of our proposed conceptual framework linking attachment insecurity to increased risk for both enacting and experiencing objectification. The most compelling evidence emerged for (a) a link between attachment anxiety and self-objectification with moderate effect sizes across both samples, and (b) an association between a less secure base within the couple relationship during pregnancy and feeling more objectified by one’s partner as well as less humanized (i.e., feeling that your partner values you more for your physical attributes and less for your non-physical attributes)

HAT-P-56b: An inflated massive Hot Jupiter transiting a bright F star followed up with K2 Campaign 0 observations

We report the discovery of HAT-P-56b by the HATNet survey, an inflated hot Jupiter transiting a bright F type star in Field 0 of NASA's K2 mission. We combine ground-based discovery and follow-up light curves with high precision photometry from K2, as well as ground-based radial velocities from TRES on the FLWO 1.5m telescope to determine the physical properties of this system. HAT-P-56b has a mass of $2.18 M_J$, radius of $1.47 R_J$, and transits its host star on a near-grazing orbit with a period of 2.7908 d. The radius of HAT-P-56b is among the largest known for a planet with $M_p > 2 M_J$. The host star has a V-band magnitude of 10.9, mass of 1.30 $M_\odot$, and radius of 1.43 $R_\odot$. The periodogram of the K2 light curve suggests the star is a $\gamma$ Dor variable. HAT-P-56b is an example of a ground-based discovery of a transiting planet, where space-based observations greatly improve the confidence in the confirmation of its planetary nature, and also improve the accuracy of the planetary parameters.Comment: 13 pages, 11 figures, accepted by A

Electromagnetic Scanning of Beef Quarters to Predict Carcass and Primal Lean Content

To study the use of electromagnetic scanning in prediction of lean content in beef carcasses and cuts, 100 beef cattle (60 steers and 40 heifers), representing a broad range in external fat thickness (. 1 to 2.9 cm) and live weight (414 to 742 kg), were selected. Chilled right sides were divided into streamlined (foreshank, brisket, and ventral plate removed) forequarters (FQ) and full hindquarters (HQ) and scanned. Primal rounds, loins, ribs, and chucks were fabricated from the right side, scanned, and physically separated into lean, fat, and bone. Prediction equations for dissected lean content and percentage of lean included the peak of the electromagnetic scan response curve (obtained from scanning the HQ or FQ), length, temperature and weight of the scanned cut, and fat thickness at the 12th rib. Using the coefficient of determination, root mean square error, and Mallows\u27 Cp statistic, the best model for each dependent variable (weight and percentage of lean) that included up to five independent variables was selected. Prediction equations for the HQ or FQ of steers accounted for 84 to 93% of the variation in lean weight of beef sides and quarters and 71 to 93% of primals. Sixty-one to 75% of the variation in percentage of lean in sides and quarters and 48 to 65% of primals was also explained. Similar results were obtained for heifer carcasses. Predicting percentage of lean in any scanned cut, rather than weight of lean, accounted for less of the variation. Weight and fat thickness contributed significantly when predicting percentage of lean. These data indicate that electromagnetic scanning is capable of objectively measuring lean content in beef quarters and primals

Spectroscopic Discovery of the Supernova 2003dh Associated with GRB 030329

We present early observations of the afterglow of the Gamma-Ray Burst (GRB) 030329 and the spectroscopic discovery of its associated supernova SN 2003dh. We obtained spectra of the afterglow of GRB 030329 each night from March 30.12 (0.6 days after the burst) to April 8.13 (UT) (9.6 days after the burst). The spectra cover a wavelength range of 350 nm to 850 nm. The early spectra consist of a power-law continuum (F_nu ~ nu^{-0.9}) with narrow emission lines originating from HII regions in the host galaxy, indicating a low redshift of z=0.1687. However, our spectra taken after 2003 Apr. 5 show broad peaks in flux characteristic of a supernova. Correcting for the afterglow emission, we find the spectrum of the supernova is remarkably similar to the type Ic `hypernova' SN 1998bw. While the presence of supernovae have been inferred from the light curves and colors of GRB afterglows in the past, this is the first direct, spectroscopic confirmation that a subset of classical gamma-ray bursts originate from supernovae.Comment: published by ApJ Letters; additional material avilable at http://cfa-www.harvard.edu/cfa/oir/Research/GRB

Two 'b's in the Beehive: The Discovery of the First Hot Jupiters in an Open Cluster

We present the discovery of two giant planets orbiting stars in Praesepe (also known as the Beehive Cluster). These are the first known hot Jupiters in an open cluster and the only planets known to orbit Sun-like, main-sequence stars in a cluster. The planets are detected from Doppler shifted radial velocities; line bisector spans and activity indices show no correlation with orbital phase, confirming the variations are caused by planetary companions. Pr0201b orbits a V=10.52 late F dwarf with a period of 4.4264 +/- 0.0070 days and has a minimum mass of 0.540 +/- 0.039 Mjup, and Pr0211b orbits a V=12.06 late G dwarf with a period of 2.1451 +/- 0.0012 days and has a minimum mass of 1.844 +/- 0.064 Mjup. The detection of 2 planets among 53 single members surveyed establishes a lower limit on the hot Jupiter frequency of 3.8 (+5.0)(-2.4) % in this metal-rich open cluster. Given the precisely known age of the cluster, this discovery also demonstrates that, in at least 2 cases, giant planet migration occurred within 600 Myr after formation. As we endeavor to learn more about the frequency and formation history of planets, environments with well-determined properties -- such as open clusters like Praesepe -- may provide essential clues to this end.Comment: 5 pages, 3 tables, 2 figures. Published in ApJ Letter